Balancing punishment, treatment when crimes are committed

Two cases illustrate how the system struggles with mentally ill offenders

By CAROL SMITH, P-I REPORTER

Updated 10:00 pm, Sunday, December 28, 2008

For a while, Nick Monostory and Thomas Gergen were next-door neighbors at Western State Hospital's ward for the criminally insane. Though they shared a hallway, and similar diagnoses, they experienced vastly different fates in the mental health and criminal courts system.

Thirty-three years ago, Monostory came home late one night and knocked a neighbor down after she asked him to simmer down.

The neighbor hit her head when she fell, and died a few days later. Monostory, who suffers from a laundry list of mental disorders, including schizoaffective disorder, was charged with second-degree murder and found not guilty by reason of insanity. In 1975, he was sent to Western, the state's hospital for the severely mentally ill.

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Now 62, he's still there -- long past any likely sentence he would have received had he been found guilty.

In 2003, Gergen shot his pregnant wife five times, killing her and their unborn child. He was initially charged with first-degree murder and first-degree manslaughter. He, too, was found not guilty by reason of insanity and sent to Western.

Unlike Monostory, however, Gergen was pronounced well enough to rejoin the community after five years and was released earlier this year. Had he been convicted of the initial charges, he could likely have faced a life term.

"From a mental health perspective, that's a great success," said King County Prosecutor Dan Satterberg. "The improvement in quality of drugs and treatment is a big change."

But such cases have also raised questions about fairness -- an issue bound to surface as courts wrestle with the fate of two high-profile slaying suspects now entangled in the criminal justice and mental health care systems.

Nearly a year ago, James Williams was charged with first-degree murder in the stabbing death of Shannon Harps in Seattle last New Year's Eve. Williams, who has a conviction for shooting a stranger at a bus stop, also has a long history of mental illness dating back to his teenage years.

He was under community supervision at the time of Harps' slaying, but according to records obtained by the Seattle P-I, was not taking medications that helped control his violent delusions.

In charging papers, Williams admitted to killing Harps and broke down crying, saying he had hoped it wasn't true -- that he maybe only wounded her after reading in the paper about "what a nice person she was."

A few months later, Isaac Zamora went on a deadly shooting spree in Skagit County that claimed six lives, including that of a sheriff's deputy. According to a task force investigating both cases, Zamora's history of mental instability was known to family and Sheriff's Office employees, but not to the corrections officer charged with overseeing him after his most recent release from jail on felony drug charges.

These two cases have put the issues of insanity and accountability on trial. They illustrate the conundrum prosecutors, jury and eventually, the public, face when dealing with untreated mental illness -- how to balance the need for punishment with the need for treatment.

'Guilty, but mentally ill'

Some argue that the legal system for dealing with cases such as Williams' and Zamora's is inadequate -- that there needs to be a new type of plea and more extended sentencing guidelines for dealing with the small subset of people with mental illness who commit violent crimes.

The insanity acquittal traditionally has not been a get-out-of-jail-free card.

"It used to be a pretty fair trade-off in terms of time a person served," Satterberg said. "People would do the same or more time at Western than they would in prison. But we can no longer assure the families of victims of that."

Earlier this month, the King County Prosecutor's Office and the state Department of Correction's joint report on the task force recommended, among dozens of potential reforms, that the state consider enacting a "guilty, but mentally ill" plea. More than a dozen states already have such pleas.

The new plea, in principle, would identify mentally ill offenders and ensure that they receive treatment in the corrections systems, while at the same time ensuring that they pay for their crimes.

Proponents of the guilty but mentally ill approach say it would avoid cases such as Gergen's, where the consequences seem out of proportion to the magnitude of the crime.

Critics, however, say the new plea will only increase the stigmas faced by people with mental illness and escalate the trend toward putting mentally ill people in jail instead of into treatment facilities.

Currently, the only alternative to traditional pleas for someone with mental illness is the not guilty by reason of insanity defense.

Insanity pleas are seldom used, however, for at least two reasons. First, they require admission that the person did commit the crime, something many defense attorneys resist.

Second, the bar for proving insanity is high. The defense must show the person does not appreciate the nature and quality of his or her acts, or that he or she didn't understand right from wrong.

"People can be extremely crazy, delusional and paranoid and not rise to that standard," said David Lovell, a research professor at the University of Washington who has studied mentally ill offenders.

As a result, most mentally ill people who commit crimes wind up in the regular corrections system, where they may or may not receive treatment. Williams, for example, did receive treatment while he was in prison. It's not apparent whether Zamora did.

Adopting a new plea that gives juries an opportunity to convict someone despite mental illness could swell the already significant numbers of prisoners with severe psychiatric issues.

"I'm going to be concerned with the issue of resources," said Corrections Secretary Eldon Vail, whose system would then be responsible for providing the medication and additional staff to treat prisoners with mental illness. "If we're going to be charged with doing it, we have to have the capacity to do it."

Mental health courts

The obvious, though difficult, solution to capacity issues in the corrections system is to prevent crime in the first place.

Putting people in jail is ultimately more expensive than providing treatment in the community, said Russell Kurth, a public defender who works in Seattle's Mental Health Court, which handles misdemeanor offenses.

The goal of mental health courts is to get more people into treatment. The courts, which are voluntary, can order treatment in lieu of jail time, and have the legal authority to enforce that people follow through. Part of the incentive for people to stay in treatment is that they won't have a record, Kurth said.

Defendants who opt to handle their cases through mental health court tend to stay in treatment longer and reoffend less, he said. "It's proven to work."

Kurth and others argued that a mental health court approach could work for some types of felony offenders as well, in the same way that drug courts route some felony offenders into drug treatment. They acknowledge that there are some crimes -- first-degree murder, arson or rape, for example -- that should not be handled that way.

For many other offenses that arise as a result of a mental disorder, and that could be prevented from reoccurring by addressing the underlying illness, jail is not the best place to accomplish that goal, advocates said.

"Criminalizing mental illness is not the answer," said Laura Rollins, whose 19-year-old brother with bipolar disorder died in jail after being forcibly subdued during a manic episode.

Earlier this month, Asotin County and the city of Clarkston entered judgments to formally accept responsibility for his death. Her brother, Tyler, was jailed on a minor offense committed while in the throes of a manic episode, she said.

"Tyler would be alive today if he'd been sent to a hospital instead of jail," she said. Rollins and her family have pushed for better training of guards in jails that house mentally ill inmates.

Redefining insanity?

The dilemma remains: how to keep the very few, extremely dangerous patients, such as Williams, from committing crimes, without making the legal consequences so harsh that they essentially punish people for having a disease.

Trying to craft a solution for such a "low-probability, but high-stakes" situation is difficult, Lovell said. "You want to minimize the risk of getting 100 dolphins for every shark you catch."

One solution that might meet both goals -- public safety without further criminalizing mental illness -- would be to alter the definition of insanity to make it broad enough to qualify more mentally ill offenders, he said.

Had Williams been sent to Western instead of jail for his original felony crime of shooting a man at a bus stop, he quite possibly would still be there, said Lovell, who served on the task force that investigated the Harps killing. (Despite his long history of mental illness, Williams did not plead insanity in that case, and subsequently went to prison for 11 years.)

One advantage of this approach is that it's easier to recommit someone to a psychiatric hospital after he or she is released from the forensics ward than it is to pull him or her back into the system if that person has been released from prison, Lovell said.

One of the key findings of the task force investigating the Harps killing was that corrections officers responsible for monitoring Williams after his release to the community didn't have the legal tools they needed to either get him hospitalized or put him back in jail once his symptoms started to escalate.

The growing number of mentally ill people in prison is a symptom of society's failure to care for them in the first place, Kurth said. "The goal," he said, "should be to get them into a hospital before they do something to go to jail."